Research Project

Proposed Research Programs

            The following research programs are developed in parallel with the research program of the QSMI snake venom group, which was designated the WHO collaborating center for venomous snake toxicology and research during 2001 and 2004.

A. The Development of Malayan Krait antivenom

Malayan krait (Bungarus candidus), a nocturnal snake prevalent in the Northeastern part of Thailand, remains the most common snake bite mortality in Thailand due to the lack of effective antivenom. This nocturnal snake has small venom apparatus which gives low yield in venom production. Its venom contains pre-synaptic neurotoxins that cause irreversible damage to the neuromuscular junctions. It is uncertain whether antivenom would be effective in reversing neuromuscular paralysis in snake bite victims.

The current antivenoms available in Thailand are mono-specific antivenom; neutralizing only one type of snake venom.  However, in certain part of Thailand, three species of hematotoxic snake can be found in the same geographical area.  First aiding a bleeding patient after snake bite in such area can be difficult. Therefore, a portable diagnostic kit would be helpful in selection of effective antivenom for snake bite victims.

Russell’s viper (Daboia russellii) is an important snake in the South and Southeast asian region.  In addition to procoagulant effect, RV bites victims may develop acute renal failure or neurotoxicity.  Pathogenesis for these manifestation is unclear. An important procoagulant component, factor X activator (RVV-X) is useful diagnostic assay for lupus coagulant and monitoring patients on heparin therapy. Cloning and expression of RVV-X would be helpful to develop a specific diagnostic assay, better antivenom, and potential novel treatment for bleeding disorders.

Arboreal green pit vipers (Trimeresurus spp.) are the most prevalent venomous snake of the South and Southeast Asian regions. Several species are responsible for human bites with variable clinical effects. The components of their relatively mild procoagulant effects are still unknown.  Correlation between each species and its clinical effect remains not clarified.  Novel molecules with potential platelet agonist and antagonist activities remain undiscovered.

Cobra venom contains neurotoxins that could be partially reversed by cobra antivenom as well as anticholinesterase.  Horse antivenom production against cobra often yield a low titer of antivenom level, which may be related to low antigenicity of crude cobra venom. A better way of immunization of horses to improve antivenom production and development of an in vitro antivenom potency test is needed.

Malayan pit viper is prevalent in the south of Thailand. MPV bites causes defibrination, hemorrhage, and severe local necrosis.

Horse antivenom is the most effective treatment for snake envenoming. However, it frequently cause adverse effects, including anaphylactoid reactions.  Modifications of horse antivenom and novel types of antivenom can decrease the problems.  Several types of interventions has been proposed but not proven. The mechanism of venom clearance is not yet entirely understood.